Consequences for maternal nutrition of reproductive stress across consecutive pregnancies

Merchant, Kathleen M; Martorell, Reynaldo; Haas, Jere D.

doi:10.1093/ajcn/52.4.616

Cited by 48 publications

(41 citation statements)

References 7 publications

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“…Merchant et al 7,8 reported that an overlap was associated with a nonsignificant decrease of 57 g in birth weight; the effect increased with the overlap duration. Studies with the appropriate design to look at birth outcomes (risk of low birth weight or prematurity) have not been conducted yet.…”

Section: Discussionmentioning

confidence: 98%

“…[1][2][3][4][5] Despite this, the practice is common. 7,8,28,29 In Bangladesh, an estimated 20% of women who were lactating and pregnant were still lactating at the beginning of the ninth month. 28 In Guatemala, 50% of pregnant women were breastfeeding an older children.…”

Section: Discussionmentioning

confidence: 99%

“…28 In Guatemala, 50% of pregnant women were breastfeeding an older children. 7,8 In Peru, 10% of women with preschoolers continued to breastfeed until the last trimester of pregnancy (G.S.M., unpublished data). Similar prevalence data for US women are not available, but the breastfeeding behavior is present.…”

Section: Discussionmentioning

confidence: 99%

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Postpartum Consequences of an Overlap of Breastfeeding and Pregnancy: Reduced Breast Milk Intake and Growth During Early Infancy

et al. 2002

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ABSTRACT. Objective. Despite cultural pressure to wean when a new pregnancy occurs, some women choose to continue breastfeeding. We determined the effect of an overlap of lactation and late pregnancy on breastfeeding and growth in early infancy.Methods. We studied 133 Peruvian pregnant women who were >18 years of age, had a child <4 years old, and who then had a vaginal birth with a healthy, normal weight infant. Of the 133 women, 68 breastfed during the last trimester of pregnancy (BFP), and 65 had not breastfed during pregnancy (NBFP). On day 2 and at 1-month postpartum, 24-hour intake of breast milk and other liquids was measured. Twice weekly home surveillance documented infant morbidity and dietary intakes. Anthropometry was taken at birth and at 1 month. Maternal anthropometric, health, and socioeconomic status data were collected pre-and postpartum.Results. Pregnant BFP mothers breastfed 5.3 ؎ 4.3 times/day. BFP and NBFP infants did not differ in breastfeeding behavior or in colostrum intake on day 2. BFP infants breastfed longer per feed and per 24 hours (35.2 minutes/24 hours) than did NBFP infants; however, 1-month intakes per feed tended to be lower among the BFP infants. After controlling for confounders, BFP infants gained 125 g less than did NBFP infants (about 15% of mean weight gain). A sustained decline would result in a ؊0.7 z score change in weight-for-age by 6 months.Conclusions. A lactation-pregnancy overlap had a negative effect on early infant outcomes. Additional studies are needed to determine whether the effect continues past 1 month of age. Pediatrics 2002;109(4). URL: http://www.pediatrics.org/cgi/content/full/109/4/e56; breastfeeding, pregnancy, overlap, breast milk volume, weight gain, infant feeding, Peru.ABBREVIATIONS. BFP, breastfed during pregnancy; NBFP, did not breastfeed during pregnancy; BMI, body mass index; SES, socioeconomic status; CI, confidence interval; OR, odds ratio. M any women throughout the world breastfeed for as long as possible to give their children the nutritional, immunologic, and emotional benefits of breastfeeding. When lactation overlaps a new pregnancy, some women choose not to wean their toddlers, although there may be strong cultural taboos against continuing to breastfeed. 1,2 The practice of continuing to breastfeed during pregnancy has been reported among US women but might not be discussed with health professionals because of anticipated criticism of the practice. [3][4][5] Breastfeeding during pregnancy is more common in some low-income countries than in the United States because shorter birth intervals increase the likelihood of a pregnancy-lactation overlap.It has been suggested that an overlap could produce suboptimal outcomes for both pregnancy and subsequent lactation. 6 -8 Dairy research has demonstrated that a complete overlap of lactation during pregnancy dramatically compromises the total production of mature milk during the next lactation period. 9 -14 A dry (nonmilking) period of approximately 2 months before calving is usual in the da...

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Postpartum Consequences of an Overlap of Breastfeeding and Pregnancy: Reduced Breast Milk Intake and Growth During Early Infancy

et al. 2002

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“…Women with greater numbers of births have been shown to suffer from additional health and nutritional complications (28) . Modern contraception use could also be a proxy for modernity and utilization of health services.…”

Section: Modern Contraceptivesmentioning

confidence: 99%

Geographic distribution and socio-economic determinants of women's nutritional status in Mali households

Gewa

Leslie

Pawloski

2012

Public Health Nutr.

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Objective: Mali is one of the poorest countries in Africa, with 72 % of its population surviving on less than $US 1?00 per day. Health and demographic indicators are bleak. With few exceptions, studies related to the health of women in Mali have largely been under-represented. In addition, in recent years a new type of malnutrition stemming from weight gain and obesity has been observed throughout Africa. The present study aimed to (i) describe geographic and health variations of women of reproductive age, (ii) describe geographic variations of household salt iodine levels and (iii) investigate potential factors associated with women's anthropometric status and use of adequately iodized salt among households in Mali. Design: Demographic and Health Survey data, multistage-stratified cluster sampling methodology. Setting: Rural and urban areas of Mali. Subjects: Non-pregnant women (n 6015) between the ages of 19 and 44 years. Results: Nineteen per cent of the women were overweight or obese while 11 % were underweight. Seventy-eight per cent of the households utilized adequately iodized salt. Underweight women were more prevalent in southern Mali, while obesity was more frequent in the north-east and within the major urban areas. Households located within the southern parts of Mali were more likely to utilize adequately iodized salt. Education, age, modern contraceptive use, breast-feeding status at time of the survey and household wealth index were significantly associated with the women's BMI or households' use of adequately iodized salt. Conclusions: The combined use of statistical and geographic system analysis contributes to improve targeting of interventions among vulnerable populations. Keywords Non-pregnant women BMI Iodized salt utilization MaliMali is one of the poorest countries in Africa, with 72 % of its population surviving on less than $US 1?00 per day. Health and demographic indicators are bleak; life expectancy from birth is 49?8 years and maternal mortality is 580 per 100 000 people. Several studies including the most recent national analysis from the Demographic and Health Surveys (DHS) examining the nutritional situation of children throughout Mali have shown significant numbers of stunted and wasted children (1) . Further, the WHO reports that approximately 30 % of children under 5 years of age are underweight, 40 % are stunted and about 4 % are overweight (2) . Recent research has shown evidence of poor nutrition among adolescent girls in Mali, suggesting that poor nutritional status is not a risk limited to childhood but extends into adolescence (3,4) . Most of the studies concerning the nutritional situation in Mali have focused primarily on infants and children and have ignored adolescents and adults. With the exception of studies related to infant feeding, reproductive health and violence against women, studies related to the health of women in Mali have largely been under-represented. Other field studies in Mali are generally dated and focus on children and infant feeding (5,6)

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“…Maternal nutritional depletion might be impli- (Merchant et al 1990a;Merchant et al 1990b). Improving access to available reproductive health services (e.g.…”

Section: Discussionmentioning

confidence: 99%

A community food system analysis as formative research for a comprehensive anemia control program in Northern Afghanistan

et al. 2009

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Consequences for maternal nutrition of reproductive stress across consecutive pregnancies

Cited by 48 publications

References 7 publications

Postpartum Consequences of an Overlap of Breastfeeding and Pregnancy: Reduced Breast Milk Intake and Growth During Early Infancy

Postpartum Consequences of an Overlap of Breastfeeding and Pregnancy: Reduced Breast Milk Intake and Growth During Early Infancy

Geographic distribution and socio-economic determinants of women's nutritional status in Mali households

A community food system analysis as formative research for a comprehensive anemia control program in Northern Afghanistan

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